Provider Demographics
NPI:1710782727
Name:HOLY TRINITY MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:HOLY TRINITY MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:JEROME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-713-7173
Mailing Address - Street 1:4152 W BLUE HERON BLVD STE 126
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-4859
Mailing Address - Country:US
Mailing Address - Phone:561-713-7173
Mailing Address - Fax:
Practice Address - Street 1:4152 W BLUE HERON BLVD STE 126
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-4859
Practice Address - Country:US
Practice Address - Phone:561-713-7173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-14
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care